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Meta-Analysis
. 2018 Oct;99(10):2100-2113.e5.
doi: 10.1016/j.apmr.2018.01.008. Epub 2018 Feb 7.

Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women

Antonio García-Hermoso  1 , Iván Cavero-Redondo  2 , Robinson Ramírez-Vélez  3 , Jonatan R Ruiz  4 , Francisco B Ortega  4 , Duck-Chul Lee  5 , Vicente Martínez-Vizcaíno  6
Affiliations
Meta-Analysis

Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women

Antonio García-Hermoso et al. Arch Phys Med Rehabil. 2018 Oct.

Abstract

Objectives: The aims of the present systematic review and meta-analysis were to determine the relationship between muscular strength and all-cause mortality risk and to examine the sex-specific impact of muscular strength on all-cause mortality in an apparently healthy population.

Data sources: Two authors systematically searched MEDLINE, EMBASE and SPORTDiscus databases and conducted manual searching of reference lists of selected articles.

Study selection: Eligible cohort studies were those that examined the association of muscular strength with all-cause mortality in an apparently healthy population. The hazard ratio (HR) estimates with 95% confidence interval (CI) were pooled by using random effects meta-analysis models after assessing heterogeneity across studies.

Data extraction: Two authors independently extracted data.

Data synthesis: Thirty-eight studies with 1,907,580 participants were included in the meta-analysis. The included studies had a total of 63,087 deaths. Higher levels of handgrip strength were associated with a reduced risk of all-cause mortality (HR=0.69; 95% CI, 0.64-0.74) compared with lower muscular strength, with a slightly stronger association in women (HR=0.60; 95% CI, 0.51-0.69) than men (HR=0.69; 95% CI, 0.62-0.77) (all P<.001). Also, adults with higher levels of muscular strength, as assessed by knee extension strength test, had a 14% lower risk of death (HR=0.86: 95% CI, 0.80-0.93; P<.001) compared with adults with lower muscular strength.

Conclusions: Higher levels of upper- and lower-body muscular strength are associated with a lower risk of mortality in adult population, regardless of age and follow-up period. Muscular strength tests can be easily performed to identify people with lower muscular strength and, consequently, with an increased risk of mortality.

Keywords: Death; Hand strength; Leg strength; Muscles.

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